PALS emergency department hypovolemia scenario

The quiz
Parents arrive with their 10-year-old with abdominal injuries caused by a bicycle accident. The mother reports that it happened about 4 hours ago, but he seems to be getting worse. The patient was wearing a helmet and there was no loss of consciousness. The patient is in obvious pain and says it is getting worse. Spinal injury has been ruled out. Vitals as follows: HR 130/min BP: 110/50mmHg Respirations: 30/min Sp02 92% on room air. Temperature 98.6 F Weight: 40 kg

about 3–5 minutes

Question 1 of 5

What type of shock are you concerned may be present here?

Question 2 of 5

What immediate intervention is indicated?

Question 3 of 5

What other step is indicated as treatment for this child?

Question 4 of 5

If this child’s heart rate does not decrease with the first fluid bolus and/or his blood pressure decreases, what is the next intervention?

Question 5 of 5

What other assessment is necessary early in the treatment of this child?

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The quiz

Correct answers

  • Compensated hypovolemic shock
  • Administer oxygen
  • IV access and the administration of NSS 20ml/kg
  • Repeat NSS 20ml/kg, re-evaluate, and if no response repeat with a third 20ml bolus
  • Measurement of and correction of blood glucose

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